Diabetes Audit 2019 - Checklist for Electronic Audits



IHS Division of Diabetes Treatment and Prevention

Annual Diabetes Care and Outcomes Audit 2019

Checklist for Electronic Audits

February 2019

|Step |1.0 Preparation |Completed? |

| |Review the detailed 2019 Audit instructions[1] with particular attention to the section on performing an electronic Audit.| |

| |Audit 2019 RPMS Patch: Make sure that the Audit 2019 software has been installed. | |

| |[If uncertain, confirm with your RPMS site manager that Diabetes Management System (DMS) Version 2.0, Patch 12 has been | |

| |successfully installed. The DMS is also referred to as namespace BDM by RPMS site managers and developers.] | |

| |Review the RPMS/DMS Diabetes Audit 2019 Instructions[2], which include information on patient selection, taxonomies, and | |

| |other specifics for performing an electronic Audit. | |

|Step |2.0 Update Site-Populated Taxonomies |Completed? |

| |Identify the labs and medications used at your site by running the “List Labs/Medications Used at this Facility” report. | |

| |(DM19 menu options: AS -> LMR) | |

| |Run the “Check Taxonomies for the 2019 DM Audit” report. (DM19 menu options: AS -> TC19) | |

| |Review and update site-populated taxonomies including Drugs and Laboratory Tests. (DM19 menu options: AS -> TU19) | |

| | | |

| |Tips: | |

| |See pages 5-7 of this document for a list of site-populated taxonomies. | |

| |Remove lab panels and place combination medications in all appropriate taxonomies. | |

|Step |3.0 Create Electronic Audit Data File |Completed? |

| |Determine which patient list you will use for your Audit, your Diabetes Registry or a template of patients with diabetes | |

| |created using QMAN. | |

| |If using the Diabetes Registry: | |

| |Find ineligible patients by running the “List Possible Inactive Pts in the DM Register” report. (DM19 menu options: AS -> | |

| |INA) | |

| |Change register status for ineligible patients. (DM19 menu options: RM- > PM) | |

| |Find newly diagnosed diabetes patients by running the “Patients with DM. Diagnosis and not on Register” report. (DM19 menu| |

| |options: AS -> DXNR) | |

| |Add eligible patients to the Diabetes Register. (DM19 menu options: RM- > PM) | |

| | | |

| |If creating a template of diabetes patient: | |

| |Create a Fileman template using QMAN. | |

| |Save the template with a name that you will remember. | |

| |Run and review a Data Quality Check report using DMS. Review the report and fix as many errors as possible in RPMS. (DM19 | |

| |menu options: AS -> DQC) | |

| |Run and review an Audit Report (Cumulative Audit) using DMS. (DM19 menu options: AR -> DM19) | |

| |Print Individual Reports if needed to troubleshoot or verify specific patient information. | |

| |Review the Diabetes Audit logic if necessary. (DM19 menu options: AS -> DAL) | |

| |Review your taxonomies if necessary. (DM19 menu options: AS -> VTAX). | |

| |Make corrections if needed and rerun the Audit Report (Cumulative Audit). | |

| |Create an Audit Export file. (DM19 menu options: AR -> DM19) | |

|Step |4.0 Upload, Process, and Submit Data via the WebAudit |Completed? |

| |Request a WebAudit account if you don’t already have one. For more information see the IHS Division of Diabetes Audit | |

| |website[3]. | |

| |Login to the WebAudit: Go to the Audit website3 and click on the “WebAudit Login” link or menu item. | |

| |Enter information about your facility using the Enter Facility Info tool. | |

| |Upload your electronic Audit data file using the Upload Data tool. Be sure to read the requirements and instructions on | |

| |the main screen before uploading. | |

| |Check for additional data errors using the Data Quality Check tool: | |

| |Fix as many errors as possible using the View/Edit Data tool or by making corrections using RPMS or other EHR. | |

| |If you make corrections using RPMS or other EHR, create and upload a new data file (see step 3.0 above). | |

| |Run and review the Audit Report and Trends Graphs. | |

| |Fix as many errors as possible using the View/Edit Data tool or by making corrections using RPMS or other EHR. | |

| |If you make corrections using RPMS or other EHR, create and upload a new data file (see step 3.0 above). | |

| |Lock the data for your facility using the Lock Facility Data tool. | |

| |Complete the Audit 2019 User Evaluation.[4] | |

|Step |5.0 Optional Activities Using the WebAudit |Completed? |

| |Download the data for all records for your facility using the Data Download tool. Use these data for additional analysis | |

| |or other local purposes. | |

| |Run and review the Means Report to see estimated mean values for selected Audit outcomes for patients from your facility. | |

Other RPMS Diabetes Audit Information

RPMS Diabetes Management System Keys:

You must have keys assigned to your user profile in RPMS in order to access some applications and functionality. You will need the following keys to fully utilize the DMS. Talk to your RPMS site manager if you are having trouble accessing the DMS application.

• BDMZMENU – This key unlocks the main DMS menu. It should be assigned to all users who need to have access to the DMS system to manage patient data, run reports, etc.

• BDMZEDIT – This key allows a user to edit patient register specific data elements

• BDMZ REGISTER MAINTENANCE – This key unlocks the register maintenance options. This key should only be given to the individuals who are responsible for register maintenance and register structure.

Users must be added as authorized users to access the Diabetes Register.

Register Status Definitions

• A-Active patients who receive their primary healthcare at a facility and who have had care at that facility within the last year.

• I-Inactive patients who have not been seen within the last two years.

• T-Transient patients seen at the clinic within the past year but who do not receive their primary diabetic care at a facility and only visit the clinic periodically for medications or other services.

• U-Unreviewed patients on the Register who have not had a chart audit and medical review.

• D-Deceased patients. Patients who are documented as deceased in the Patient Registration application will appear in DMS as deceased; however documenting that a patient is deceased in DMS will only appear in the DMS registry.

• N-Non-IHS patients who receive their diabetes care at a facility.

• L-Lost to Follow-Up patients seen at a facility within the past two years but who have not had a visit in the last year.

Site-Populated Taxonomies: Medications

DM AUDIT ACE INHIBITORS

Benazepril (Lotensin)

Benazepril and hydrochlorothiazide (Lotensin HCT)

Benazepril and amlodipine (Lotrel)

Captopril (Capoten)

Captopril and hydrochlorothiazide (Capozide)

Enalapril (Vasotec)

Enalapril and hydrochlorothiazide (Vaseretic)

Enalapril and diltiazem (Teczem)

Enalapril and felodipine (Lexxel)

Fosinopril (Monopril)

Lisinopril (Prinivil, Zestril)

Lisinopril and hydrochlorothiazide (Prinzide, Zestoretic)

Moexipril (Univasc)

Perindopril (Aceon)

Quinapril (Accupril)

Ramipril (Altace)

Trandolapril (Mavik)

Trandolapril and verapamil (Tarka)

Also, include Angiotensin II Receptor Blockers (ARB) in this Taxonomy

Azilsartan (Edarbi)

Candesartan (Atacand)

Eprosartan (Teveten)

Irbsesartan (Avapro)

Irbesartan and hydrochlorothizide (Avalide)

Losartan (Cozaar)

Losartan and hydrochlorothiazide (Cozaar)

Olmesartan (Benicar)

Telmisartan (Micardis)

Valsartan (Diovan)

Valsartan and hydrochlorothizide (Diovan/HCT)

DM AUDIT ACARBOSE DRUGS

Acarbose (Precose)

Miglitol (Glyset)

DM AUDIT AMYLIN ANALOGS

Pramlinitide (Symlin)

DM AUDIT ANTIPLATELET DRUGS

Any non-aspirin anti-platelet product including Heparin and Warfarin (Coumadin)

Apixaban (Eliquis)

Aspirin and Dipyridamole (Aggrenox)

Cilistazol (Pletal)

Clopidogrel (Plavix)

Dabigatran Etexilate (Pradaxa)

Dipyridamole (Persantine)

Edoxaban (Sarvaysa)

Ticagrelor (Brilinta)

Ticlopidine (Ticlid)

Prasugrel (Effient)

Rivaroxaban (Xarelto)

Vorapaxar (Zontivity)

DM AUDIT ASPIRIN DRUGS

Any Aspirin (ASA) or Aspirin containing product (Verasa, Rubrasa)

DM AUDIT BROMOCRIPTINE DRUGS

Bromocriptine 0.8 mg (Cycloset)

DM AUDIT COLESEVELAM DRUGS

Colesevelam (Welchol)

DM AUDIT DPP4 INHIBITOR DRUGS

Alogliptin (Nesina)

Alogliptin and Metformin (Kazano)

Alogliptin and Pioglitazone (Oseni)

Linagliptin (Trajenta)

Linagliptin and Metformin (Jentadueto)

Sitagliptin (Januvia,)

Sitagliptin and metformin (Janumet)

Sitagliptin and Simvastatin (Juvisync)

Saxagliptin (Onglyza)

Saxagliptin and Metformin (Kombiglyze XR)

DM AUDIT GLP-1 ANALOG DRUGS

Albiglutide (Tanzeum)

Dulaglutide (Trulicity)

Liraglutide (Victoza)

Exenatide (Byetta, Bydureon)

DM AUDIT INSULIN DRUGS

Any Insulin product in Drug File

Insulin, REG

NPH

Lente

Ultralente

Insulin Lispro (Humalog)

Insulin Glargine (Lantus)

Insulin Detemir (Levimir)

Insulin Aspart (Novolog)

Insulin Glulisine (Apidra

Inhalable Insulin (Affreza, Exubera – discontinued 2007)

Pre-Mixed Insulins (70/30, 75/25)

DM AUDIT METFORMIN DRUGS

Metformin (Glucophage, Fortamet, Glumetza, Riomet)

Metformin extended release (Glucophage XR, Glumetza)

Metformin and Alogliptin (Kazano)

Metformin and Canagliflozin (Invokamet)

Metformin and Dapagliflozin (Xigduo)

Metformin and Glipizide (Metaglip)

Metformin and Glyburide (Glucovance)

Metformin and Linagliptin (Jentadueto)

Metformin and Rosiglitazone(Avandamet)

Metformin and Pioglitazone (Actoplus met)

Metformin and Sitagliptin (Janumet)

Metformin and Repaglinide (PrandiMet)

Metformin and Saxagliptin (Kombiglyze XR)

DM AUDIT SGLT-2 DRUGS

Canagliflozin (Invokana)

Dapagliflozin (Farxiga)

Empagliflozen (Jardiance)

DM AUDIT STATIN DRUGS

Atorvastatin (Lipitor)

Atorvastatin and Amlodipine (Caduet)

Atorvastatin and Ezetimibe (Liptruzet)

Fluvastatin (Lescol)

Lovastatin (Mevacor, Altocor, Altoprev)

Lovastatin and Niacin (Advicor)

Pravastatin (Pravachol)

Pitivistatin (Livalo)

Rosuvastatin (Crestor)

Simvastatin (Zocor)

Simvastatin and Ezetimibe (Vytorin)

Simvastatin and Niacin (Simcor)

Simvastatin and Sitagliptin (Juvisync)

DM AUDIT SULFONYLUREA DRUGS

Acetohexamide (Dymelor)

Chlorpropamide (Diabinese)

Glimepiride (Amaryl)

Glimepiride and pioglitazone (Duetact)

Glimepiride and rosiglitazone (Avandaryl)

Glipizide (Glucotrol)

Glipizide and metformin (Metaglip)

Glyburide (Diabeta,Micronase,Glynase, Glycron)

Glyburide and metformin (GlucoVance)

Tolazamide (Tolinase)

Tolbutamide (Orinase)

DM AUDIT SULFONYLUREA-LIKE DRUGS

Nateglinide (Starlix)

Repaglinide (Prandin)

Repaglinide and Metformin (PrandiMet)

Site-Populated Taxonomies: Lab

Do not include lab panels in your lab taxonomies

BGP GPRA ESTIMATED GFR TAX

Estimated GFR, Calculated GFR, _GFR, Estimated, _GFR Non-African American, EST GFR, eGFR

BGP GPRA CREATINE KINASE TAX

CK, CPK, Creatine Kinase, Total CK

DM AUDIT ALT TAX

ALT, SGPT

DM AUDIT ALT TAX

AST, SGOT

DM AUDIT CREATININE TAX

(Be careful not to include any tests for Urine Creatinine.)

Creatinine, POC Creatinine, Serum Creatinine, _Creatinine

DM AUDIT HDL TAX

HDL, HDL Cholesterol, POC HDL Cholesterol, _HDL Cholesterol

DM AUDIT HBA1C TAX

Hemoglobin A1C, A1C, HGB A1C, HBA1C, HA1C, POC HEMOGLOBIN A1C, _A1C

DM AUDIT LDL CHOLESTEROL TAX

LDL, Direct LDL, LDL Cholesterol, LDL Cholesterol (calc), POC LDL Cholesterol, _LDL Cholesterol

DM AUDIT MICROALBUMINURIA TAX

Microalbumin, _Microalbumin, Albumin, Urine, POC Microalbumin

DM AUDIT QUANT UACR TAX

Microalbumin/Creatinine Ratio measured in actual numeric values (mg/g Creatinine). Look for tests A/C, A:C, Albumin/Creatinine, _A/C, -A/C, asterisk (*)A/C, Microalbumin/Creatinine, M-Alb/Creatinine.

DM AUDIT TB TAX

QFT-G, T SPOT-TB, Quantiferon GOLD

DM AUDIT TRIGLYCERIDE TAX

Triglyceride, POC Triglyceride, _Triglyceride

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